Key Points of Mistletoe Therapy. Robbin Coedy B.Sc., M.Sc.

Transcription

1 Key Points of Mistletoe Therapy Robbin Coedy B.Sc., M.Sc.

2 Basic Rules of Mistletoe Therapy 1) Inject in the abdomen (preferred), thigh or upper arm 2) Most protocols are 3x/week 3) Start at a low dose 4) Work up in steps 5) Stay at the dose where there is a positive reaction 6) Increase the dose once no more reaction

3 Normal Dose Escalation Most patients 1mg 5mg 10mg 20mg 30mg 50mg Patients with tumours, or who had stage III disease continue: 70mg 80mg 100mg Patients with tumours continue: 100mg 150mg 200mg 100mg 150mg 200mg

4 Helixor 8 Different Doses Ampoule Volume Content (fresh mistletoe) Helixor 0.1 mg 1 ml extract from 0.1 mg mistletoe Helixor 1 mg 1 ml extract from 1 mg mistletoe Helixor 5 mg 1 ml extract from 5 mg mistletoe Helixor 10 mg 1 ml extract from 10 mg mistletoe Helixor 20 mg 1 ml extract from 20 mg mistletoe Helixor 30 mg 1 ml extract from 30 mg mistletoe Helixor 50 mg 1 ml extract from 50 mg mistletoe Helixor 100 mg 2 ml extract from 100 mg mistletoe

5 Mode of Application: Series Packs Package SE I SE II SE IV Doses per pack 1mg 10mg 20mg 1mg 10mg 20mg 1mg 20mg 30mg 5mg 20mg 30mg 5mg 30mg 50mg 5mg 30mg 50mg 10mg 30mg 50mg NOTE: SE III is used only for rapid dose increases for inpatients, followed by SE IV.

6 Mode of Application: Original and Great Packs OP (Original Pack) available in 8 Ampoules of the same dose: 0.1mg, 1mg, 5mg, 10mg, 20mg, 30mg, 50mg, 100mg GP (Great Pack) available in 50 Ampoules of the same dose: 50mg, 100mg

7 Administration Active Therapy SOLID Tumour Administration time Dose (mg) Monday Wednesday Friday PACK Week Week Week Week SE I SE II Week Week SE IV Week Week 8 70 (20+50) 70 (20+50) 80 (30+50) SE IV + Week 9 80 (30+50) 100 (50+50) 100 (50+50) 50mg OP Week (50+50) mg GP + Week 11 and on mg OP

8 Administration Prevention of Recurrence Administration time Dose (mg) Monday Wednesday Friday PACK Week Week Week Week SE I SE II Week Week SE IV Week Weeks 8 and 9 BREAK Week Week Week Week Week wk BREAK SE IV SE IV Repeat 2x SE IV then 2wk break

9 Administration Sensitive Patients SOLID Tumour Administration time Dose (mg) Monday Wednesday Friday PACK Week Week OP 1mg Week Week OP 5mg Week Week Week OP 10mg Week Week Week OP 20mg Week Then 30mg etc until reaction

10 Administration Leukemia/Lymphoma/Myeloma Administration time Dose (mg) DAILY 1 st 8 days 1mg OP 2 nd 8 days 5mg OP 3 rd 8 days 10mg OP Week 4 Week 5 Week 6 Maintenance SE II SE IV SE IV + 50mg OP Will depend on the cancer: 100mg up to 200mg daily or rotation of doses 3x/week FREE PATIENT ADVICE

11 Duration of Helixor Therapy I. In case of prevention of relapse after curative surgery: intensive treatment in the first two years, followed by phasing out: Third year: 3 weeks pause after every 2 nd series pack (= 13 series per year) Fourth year: 4 weeks pause after every 2 nd series pack (= 11 series per year) Fifth year: 8 weeks pause after every 2 nd series pack (= 8 series per year) II. In case of active treatment where cancer is still present: no pauses Helixor as a permanent, palliative treatment

12 What to Do With Common/Desired Reactions Is there a skin reaction? No Is there a fever or flu-like symptoms? No Continue to next dose on normal schedule Yes Yes Is it greater than 5cm in diameter? No Yes Pause the therapy and resume at 1 concentration steps lower only once temperature is below 38 C Continue at the last given dose, once the reaction has subsided Pause the therapy and resume at 2 concentration steps lower only once the reaction has completely disappeared

13 Choice of Helixor A Characteristics: lower lectin content, less cytotoxic, well-tolerated, strong DNA-protection Patient: Concomitant therapies/diseases: Tumour: reduced general state of health very sensitive patients children, youth before and during chemo or radiation allergic/atopic disease intolerance to other mistletoe preparations autoimmune disease brain, head and neck lung prostate some lymphoma, leukemia, myeloma

14 Choice of Helixor M Characteristics: higher lectin content, more cytotoxic, strongest inflammatory reaction, greatest tumour-inhibiting effect Patient: Tumour: Special administrations: relatively good general state of health robust patients any solid tumour where you don t need A IV, intratumoural osteoarthritis (i.c.)

15 Choice of Helixor P Characteristics: highest lectin content, most cytotoxic in the majority of tumour cell lines, less tolerable, most effective in stimulating eosinophils and phagocytotic activity of granulocytes Patient: Tumour: sufficient general condition strong and younger patients malignant melanoma sarcoma testicular cancer malignant lymphoma chronic lymphocytic leukaemia slim or premenopausal breast cancer Special administrations: Lyme disease

16 Choosing the Type of Mistletoe (Solid Tumour) Does the Patient Have Any of the Following: Allergies/sensitivities/autoimmune/atopic disease? Brain, head, neck, prostate, or lung tumours/mets? Concurrent/planned chemo or radiation? Poor general state of health? HELIXOR P Yes No Cancer type: Sarcoma; Skin; Renal; Testicular; Breast (slim, premenopausal) Yes No HELIXOR A HELIXOR M Does NOT include lymphomas, leukemias, myelomas

17 Choosing the Type of Mistletoe (Systemic) Does the Patient Have Any of the Following: Allergies/sensitivities/autoimmune/atopic disease? Brain, head, neck, prostate, or lung tumours/mets? Concurrent/planned chemo or radiation? Poor general state of health? HELIXOR P Yes No Cancer type: CLL Non-Hodgkin s Lymphoma Hodgkin s Lymphoma Yes No HELIXOR A Includes lymphomas, leukemias, myelomas

18 Possible Side Effects of HELIXOR Therapy Side Effect Frequency Measures Local inflammatory reactions at the injection site > 5cm Fever > 38ºC, flu-like symptoms Swelling of regional lymph nodes Allergic reaction (generalized itching, nettle-rash, few cases of bronchospasm, angioneurotic edema Anaphylactic reaction Frequent (initial phase) Occasional Rare Occasional Single cases transitory interruption of therapy after complete regression, dose reduction no antiphlogistics stop taking HELIXOR use anti-allergic treatment Activation of inflammation Single cases elimination of the focus

19 Immunological Effects of Mistletoe Extracts Activation of antigen-presenting cells (monocytes, macrophages, dendritic cells) Increase of granulocytes: neutrophils, eosinophils after 1 month Increase of phagocytosis activity Increase and activation of lymphocytes (CD4+, CD25+ ) Increase of FasL on lymphocytes Increase of Natural Killer (NK) cells and of NK activity Modulation of cytokine release: TNF-, IL-1, IL-6, IL-2, IL12, IFN-, IL-4, IL-5, IL-10, GM-CSF Induction of antibodies to mistletoe antigens (esp. anti-ml antibodies) Berg, P.A., Stein, G.M.: DMW 126, 2001, (modified and updated 4/2002)

20 Cautions for HELIXOR Therapy Contraindication Acute inflammatory diseases High fever Allergic/Atopic/Autoimmune disease or Hyperthyroidism Pregnancy Interferon and other cytokine treatment Mixing with other substances in same syringe Known allergy Measures Transitory interruption of therapy Start very slowly with Original Packs only Only in progressive cancer Cannot be used concurrently Do not do this risk of precipitates Do not use

21 Precautions for Subcutaneous Injection Never inject in: inflamed skin areas In order to avoid: booster effects fresh postoperative scars swelling and inflammation irridation fields impaired reabsorption the breast or the accessory arm after breast surgery risk of lymphedema or infection

22 Getting Help CANADA/US / GERMANY